Agenda. Making the Connection. Facts about ASD. Respite Presentation. Agenda. Facts about ASD. Triad of Impairments. 3 Diagnoses on spectrum

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1 Making the Connection Respite Presentation Agenda Agenda Facts about ASD Triad of Impairments 3 Diagnoses on spectrum Characteristics of ASD Behaviour Facts about ASD It is the most common form of any neurological disorder or severe developmental disability of childhood The prevalence is roughly one in 165 children The quality of life and adaptation for students with ASD is made difficult because of comorbid disorders (Szatmari, 2006) 1

2 Comorbid Disorders All have some kind of cognitive or learning disability 50% of children with ASD have a developmental disability Others have less apparent disabilities that are no less difficult to cope with. Nearly 60% develop a mental health problem (attention deficit disorder, mood disorder or an anxiety disorder) (Szatmari, 2006) Rates of accompanying mental health problems in children with autism are also greater than for any other developmental disability About 50% of children with an ASD have severe communication impairments so that they are unable to speak as adults These problems last longer and cause more impairments in quality of life than any other problem of childhood (Szatmari, 2006) Autism Spectrum Disorders (ASDs) Autism Spectrum Disorders Autism PDD-NOS Asperger Syndrome 2

3 Triad of Impairments Communication Communication Social Behaviour Social Autism A disorder in which symptoms emerge before 3 years of age. Deficits in social interaction, social communication and produces unusual and restricted behaviours It interferes with typical development, producing a profound and life-long social disability. (Klin et al., 2003) Pervasive Developmental Disorder- Not Otherwise Specified. Children with an unusual developmental pattern in: Communication Social interaction Restricted interests & attention These individuals DO NOT fully meet diagnostic criteria for Autism or Asperger syndrome. 3

4 Asperger Syndrome Students with Asperger syndrome display similar impairments in social interaction and restricted patterns of interests. They display fewer delays in language and cognitive abilities. Unlike students with autism they are interested in others but lack the social insight and communication skills to successfully follow up their interest. The more things change, the more they stay the same. Characteristics of Autism Spectrum Disorders that directly influence behaviour & learning: Processing inputs and integrating the Senses 4

5 Perceptual and sensory processing issues Oversensitive to some inputs and under sensitive to others (Iarocci et al., 2006; Weimar et al., 2001) Avoid inputs causing discomfort Seek those which are pleasurable Sensory Processing & Developmental Outcomes There are 3 patterns of observable behavioural responses: Over reactivity Sensitive to point of discomfort compelled to withdraw from sensations (Liss et al., 2003) 5

6 Sensory Processing & Developmental Outcomes There are 3 patterns of observable behavioural responses: Underreactivity Seek out sensation and/or apparent insensitivity to pain Sensory Processing & Developmental Outcomes There are 3 patterns of observable behavioural responses: Sensory Seeking Using repetitive motor behaviour to seek out sensory stimulation Social Deficits (Relating to Self and Others) 6

7 Joint Attention Joint attention is the ability share attention between another person, an object, and or event to share social awareness Impairments in joint attention have significant developmental consequences: Social Skills Language Development (Volkmar et al., 2005) Impairments in joint attention have significant developmental consequences: The ability to have social conversations Recognition and understanding of non-verbal body language 7

8 Eye Gaze of TD Adults Triangular Scan Path (Pelphry et al., 2002) Adults with ASD (Pelphry et al., 2002) ASD and Eye Gaze (Schultz, 2005; Klin et al. 2003) 8

9 Brain activity of a typically developing adolescent during a social and object oriented tasks The red and yellow areas of the typically developing adolescent shows brain activity during a recognition of faces and the blue shows brain activity in non-face activities. Typically developing adolescent Adolescent with an ASD Lack Of Social And Emotional Reciprocity Child does not clearly demonstrate sympathy, empathy, or altruism in a way that typically guides pattern of interactions with others. (adapted from Siegel, 2003) 9

10 Lack Of Social And Emotional Reciprocity Doesn t understand the effect of his behaviour on others Usually won t respond to social praise and/or physical affection. Hasn t a concept about pleasing others Lacks An Adequate Theory Of Mind Does not understand that others have beliefs different from his or her own Does not understand deception Mistakes disagreement for lying (Klin et al., 2003) Lack of Awareness of Others Child doesn t notice social events and people happening around him He misses social, nonverbal, and verbal cues that would explain what is happening around him (adapted Siegel, 2003; Frith 2003) 10

11 Instrumental learning style-more readily learns things that result in self-satisfaction His motivation to please is locked on himself Solitary Individuals with Autism may appear uninterested in social interaction rather it may be due to: Lack of language Joint attention Experience (Rutherford and Rogers, 2003) Attention in ASD: Shifting 3 operations The ability to: disengage attention from an object in one location shift attention to a new object in a different location re-engage attention on the new object (Bryson et al., 2004:16) 11

12 Sticky Attention People with ASD experience significant difficulty disengaging visual attention (Bryson et al., 2004:16) Developmental Importance of Imitation All through childhood, imitation becomes an important learning strategy TD children have developed these skills at around 18 months of age ( 1999 Flavell, (Mundy, 2006; Lack Of Social Imitation Students with an ASD, unlike their typically developing peers, do not easily learn social rules from their environment. Motor imitation and imitation dealing with nonsocial issues appears to be less affected 12

13 Deficits in Social Communication Delays in or lack of speech Deficits in Social Communication Poor conversational communication skills Deficits in Social Communication Lack of social play 13

14 Profound Disturbance Of Social Language Cannot use context to understand Salience and attention limited to only what is being said Emotions and nonverbal are not processed (Quill, 2000) May become angry and/or withdrawn if rebuffed Hesitant or makes clumsy social bids with other children Unique Behaviours 14

15 Restricted Interests Repetitive Behaviours The student gets stuck on repetitive and restricted motor behaviours. (South et al., 2005) Insistence On Sameness This helps him/her deal with the risk of the unknown, unexpected change, and transitions. (Frith, 2003) 15

16 Executive Functioning May have difficulty in: Predicting future events Understanding consequences Transitioning from one activity to another (Kenworthy et al., 2005) Behaviour: Refusal when asked to do the movements to a song or to join a play group independently. ASD function: The individual with ASD often will have imitation deficit thus are unable to follow other students in motor imitation. Behaviour: Seems uninterested, defiant, purposefully not attending to instructions ASD function: Joint Attention Deficit He cannot follow a point or reference an object upon verbal command meaning the loss of critical social and academic information. 16

17 Behaviour: Appears rude, behavioural responses are inconsistent with what is happening in current situation, not interested in others. ASD function: He or she lacks social and emotional perspective-taking skills. Behaviour: Refuses to make eye contact or makes very fleeting contact. ASD function: Impaired ability to use eye gaze, makes mistakes in where he or she looks and misses social information which would help him or her understand what is happening. Behaviour: Can t play successfully with other children (e.g., trouble turn-taking or sharing), and/or play is atypical (e.g., lining up toys) ASD function: Repetitive behaviours; can t engage in imaginative play; social communication deficits. 17

18 Behaviour: Repeats words after they are said to him or her; begins to talk without reference to listener s needs; can t repair or terminate a conversation appropriately ASD function: May use echolalia as a way to increase the time needed for verbal processing; missing an understanding of the pragmatics of conversation. 18